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The Layman’s Guide to Autism: What can I do if I see a stranger with autism having a meltdown?

Posted on May 5, 2019 by Ann

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At All In, we sometimes get interesting questions from the general public, like “Do people with autism understand sarcasm?” and “How can I tell if someone has cerebral palsy or autism?”

The Layman’s Guide to Autism provides simplified answers to real questions from laymen


Today, we will be answering this question from our friend, Tee Eng:

What should I do if I see a stranger with autism having a meltdown?

Many children and adults with autism experience meltdowns*.

People often confuse an autism meltdown with a temper tantrum. If a child is having a meltdown, it is easy for us to judge and blame it on bad parenting. If an adult is having a meltdown, we may find it scary and incomprehensible. That is why it is important to understand that an autism meltdown is not bad, wilful or manipulative behaviour.

To start, let’s understand what a meltdown is. It is:

[…] an intense response to overwhelming situations. It happens when someone becomes completely overwhelmed by their current situation and temporarily loses behavioural control.  This loss of control can be expressed verbally (e.g. shouting, screaming, crying), physically (e.g. kicking, lashing out, biting) or in both ways. […] (Source: National Autistic Society)

Here is how Ashlea McKay describes it in her article The M Word: We Need to Talk About Adult Autistic Meltdowns:

A meltdown is not a word you use to describe a bad day. It’s not a panic attack. It’s not a mental health episode. It’s not a tantrum and it’s not something a small child does several times a day- unless of course that child is autistic.

It is the complete loss of emotional control experienced by an autistic person. It doesn’t last long but once triggered, there’s no stopping it. Meltdowns are emotional avalanches that run their course whether you or the autistic person having it likes it or not. They can happen at anytime and can be caused by a number of factors including: environmental stimuli, stress, uncertainty, rapid and impactful change and much more. It really depends on the individual.

Neither the person with autism nor his or her caregiver should be blamed for the situation.

If a caregiver is around

If a caregiver is nearby, he or she will most likely take steps to manage the meltdown. Here are ways you can help:

1. Be calm and kind in your response

Firstly, stay calm yourself. It would not be helpful if you just stand and stare at them or show any form of negative expression on your face (e.g. fear, irritation, disgust).

Secondly, try to catch the caregiver’s eyes, give him or her a reassuring smile and tell him or her that “It’s okay”. This will help the caregiver feel less alone and fearful about causing an inconvenience to the public.

Last and not least, try not to act as though you know better by telling the caregiver what to do either, e.g. “You need to discipline that child”. In fact, the caregiver has the greatest knowledge of how to handle the situation, not you.

Do understand that a meltdown in a public place is a difficult situation for a caregiver. Therefore, letting the caregiver know that he or she is supported and not being judged will help a lot.

2. Let the caregiver take the lead

As mentioned, the caregiver has the greatest knowledge and should have some meltdown soothing strategies up his or her sleeve. For example, he or she may ask for help in removing sensory triggers that might have caused the meltdown, for more space to help the person with autism calm down, or assistance to move dangerous objects away.

You can help by calmly carrying out the requests.

3. Offer your help to make things easier for the caregiver

I think the best response I’ve ever had is from a lovely lady who asked if I needed any help or if I would like her to carry my bags to help me to a safe place. My son was having a meltdown at the top of the escalator in M&S. I accepted her offer of help and she carried my bags and also picked up my son’s shoes after he had thrown them as I was trying to get him down the stairs. Before she came along, lots of people just walked past staring at us. Getting him outside helped to calm him down. I don’t like people to try to talk to my son when he is having a meltdown as I find this most unhelpful, I would prefer people to just leave him to me. (Parent on Autism Jersey)

You can also observe and offer your help in other matters that will allow caregivers to focus on managing the meltdown. Here are some possibilities:

  1. If there are young children with them, you can keep an eye on them to make sure that the children are safe.
  2. If they have their hands full, you can help them carry their things.
  3. If they are trying to make their way to a quieter place, you can help them open doors and open up a path so that they can get there more easily.
  4. If things have fallen off or over, you can help to pick them up or put them back in place.
  5. If you are familiar with the place, you can suggest to the caregiver where they can go to calm the person with autism down.

These gestures of kindness can help relieve a caregiver’s stress, but do remember to check respectfully with the caregiver if he or she is fine with you doing any of these. If you take things into your hands, you might be adding to his or her problems.

4. Keep your voice low and calm at all times

The person with autism might be experiencing sensory overload. Shouting or speaking at a high-pitched voice will not help matters.


If no caregiver is around

If no caregiver is around, here are the steps that you can take to help:

1. Make space for the person

Create a quieter space for the person if you can. For example, if possible, you can ask people to move along and not to stare.

Alternatively, if there are other people who are calm and willing to help, you can get them to stand around the person to create a calming container.

Depending on the severity of the meltdown, you might want assess if it is safe and appropriate to lead the person to another place. (Do not attempt to do so if the meltdown is severe.)

2. Reduce stimulation

Help the person calm down by removing or asking to remove as much stimulation as possible. Examples include lowering the volume of sounds, dimming the lights, and removing the source of a sharp scent.

3. Give the person time and observe him or her to make sure the person is okay

Give the person having a meltdown some time to recover. Stay close by to observe them to make sure they are okay.

4. Gently ask the person if he or she is okay

When the person looks like he or she is quieting down, or if the meltdown is mild, you can gently ask the person if he or she is okay.

Doing this signals to the person that you are present and willing to help. He or she might be overwhelmed and unable to respond, but a low friendly voice might soothe him or her. Do not insist on a response from the person or in fact, even expect a response.

Remember to keep your voice low and gentle. The person with autism might be experiencing sensory overload. Shouting or speaking at a high-pitched voice will not be helpful.

5. Reassure the person

Ashlea McKay described the sensation of a meltdown in her article:

Meltdowns are a fact of autistic life. Telling an autistic person to up their resilience isn’t helpful. That can actually make it worse. I can only speak for myself, but when I have a meltdown or when I can feel myself heading for one, I get very worried about the impact on other people. Am I disturbing them? Am I making them feel uncomfortable? Are the going to view me as immature or irrational? Will this hurt my career prospects? These are the thoughts that are spiralling through my mind. They fuel my anxiety and speed up that loss of control.

When the person has quietened down, it might be helpful to reassure the person calmly. It can be a simple repetition of “it’s okay, it’s okay”. He or she may not understand you but if you keep your voice calm, low and friendly, the tone might eventually get through.

6. Never do anything to the person 

In general, you should not physically touch the person as it may escalate the situation. In the event of an emergency (e.g. the person is about to do something dangerous and you need to hold him or her back), explain calmly if you are able, “I am going to hold you for your safety. It is okay. Don’t be scared.”

 


Thank you for taking steps to understand how you can help the autism community by reading this article. Let’s all make a difference together!

This article was written with the invaluable inputs from Ms Choo Kah Ying, mother of an autistic child and founder of A Mother’s Wish.

* Please note that we have used “meltdown” as a frequently used colloquial term, without any intention of negative connotations. Other terms used by professionals include distress, emotionally overwhelmed etc.

[Updated on 9 May 2019]

Read more

The Layman’s Guide to Autism: What is the difference between Asperger’s Syndrome and Autism?

The Layman’s Guide to Autism: How can I tell if someone has autism?

An Evil Creature Who Didn’t Belong: Perils of a Late Diagnosis

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